Maxillary Ameloblastic Fibroma Mimicking Dentigerous Cyst in a Child: A Case Report

Ameloblastic fibroma (AF), an exceedingly rare benign mixed odontogenic tumor, scarcely occurs in the anterior region of the maxilla. This case report aims to delineate the formidable challenges faced during the early diagnosis of such cases, with the ultimate goal of averting missed diagnoses.

A 6-year-old female patient presented with the delayed eruption of bilateral maxillary central incisors. As early as 2 years old, tooth 62 was found to be impacted, accompanied by a supernumerary tooth in the anterior maxilla upon X-ray examination at another facility. Currently, for supernumerary tooth extraction, the child visited our hospital. Cone-beam Computed Tomography (CBCT) disclosed a supernumerary tooth between 11 and 21, along with a well-defined 5mm×6mm×6mm low-density shadow encircling the crown of impacted permanent tooth 62. The clinical diagnosis was anterior maxillary supernumerary tooth, impacted 62, and dentigerous cyst.

Maxillary mass resection, extraction of impacted 62, and removal of the supernumerary tooth were carried out. Post-operative pathology confirmed AF, and long-term follow-up revealed no tumor recurrence.

Despite its rarity, AF should be contemplated in pediatric patients with tooth eruption delay and radiographic low-density lesions with irregular edge. This case offers invaluable insights for clinicians in diagnosing and managing small, early-stage lesions. Probing into the causes of non-erupted deciduous teeth may contribute to early lesion detection.